|
 Among more than 6,000 men and women who worked at "ground zero" in
the last few months of 2001, the risk of heart attack or stroke more
than 10 years later was up to three times higher among those with
PTSD, the study team found.
Neither exposure to dust from the site, nor depression explained the
results, researchers note in the journal Circulation: Cardiovascular
Quality and Outcomes.
The implications of the research go beyond ground zero clean-up
workers, said senior study author Dr. Alfredo Morabia of the City
University of New York and Columbia University's Mailman School of
Public Health.
"The message for everyone suffering from PTSD, whether they are men
or women, is that they are at higher risk of heart attack and
stroke," Morabia told Reuters Health. "And they should very
seriously try to reduce their classic risk factors for
cardiovascular disease, such as smoking, high cholesterol and high
blood pressure."
A person can develop PTSD after experiencing a traumatic event, such
as war or violent crime, a natural disaster, physical abuse, sexual
assault or a horrifying accident. People with PTSD often feel
stressed, anxious and afraid long after the initial trauma has
passed and they can be plagued by flashbacks, nightmares, trouble
sleeping and other distressing symptoms.
Morabia and his colleagues analyzed data on 6,481 non-firefighter,
blue collar workers and volunteers who participated in rescue,
recovery and clean-up activities at ground zero in the initial days
and months following the World Trade Center attack. These men and
women began participating in a long-term, in-depth health monitoring
and treatment program in 2002.
For the current study, researchers focused on the workers' health
status during the years 2012 to 2016, examining their medical
records and their responses in personal interviews. The study team
also adjusted their analysis to account for how much dust workers
were exposed to at the site, diagnoses of depression, as well as
blood pressure, blood fats, weight and smoking.
About 20 percent of the men and 26 percent of the women had PTSD
during the study period - a rate roughly double that of the general
population, researchers note. Overall, rates of heart attack during
this follow-up period were 2.22 times higher among study
participants with PTSD compared to those without it, and rates of
stroke were 2.51 times higher with PTSD.
[to top of second column] |
In men with PTSD but free of depression, rates of heart attack and
stroke together were 1.88 to 2.27 times higher than in men without
PTSD. There was little difference in the results between men and
women.
Morabia said he hopes the new findings will encourage officials to
add heart disease to the World Trade Center Health Program's covered
conditions, which currently include respiratory illnesses and a
variety of cancers.
No one knows exactly how PTSD might work to increase the risk of
heart disease, but Morabia suspects the psychological condition "may
stimulate the production of inflammatory cells that then go into the
blood vessels and create atherosclerosis."
One big advantage this study has over previous ones linking PTSD to
heart disease is that it followed people over time to see who
experienced heart attacks and strokes, said Dr. Mark Huffman of
Northwestern University's Feinberg School of Medicine and the Bluhm
Cardiovascular Institute at Northwestern Medicine in Chicago.
Huffman, who wasn't involved in the study, said future research
should look into whether treatment of PTSD would lead to a reduction
of cardiovascular events.
But even without that, he said, "if I am taking care of a patient
with PTSD, I really want them to get treatment for PTSD."
"The nice thing about this study is that it has very good follow-up
and clear measurements. That sets it apart," said Dr. Katie
Berlacher of the University of Pittsburgh Medical Center, who wasn't
involved in the study.
And that means there's a good chance that PTSD will be added to the
list of risk factors for cardiovascular disease, Berlacher noted.
"It's good for us to have something like this to say we have proof
now. So we'll be able to say this is something you should treat,
just like you treat hypertension."
SOURCE: https://bit.ly/2u6Rrcq Circulation: Cardiovascular Quality
and Outcomes, online July 10, 2018.
[© 2018 Thomson Reuters. All rights
reserved.] Copyright 2018 Reuters. All rights reserved. This material may not be published,
broadcast, rewritten or redistributed.
Thompson Reuters is solely responsible for this content. |
